Avon LMCs Newsletter on 09-10-24

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The ALMC Newsletter

Welcome to our weekly newsletter, sharing the latest news and topics of interest for practices.

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– LATEST NEWS –

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It’s such a treat to have “Strictly” back on our screen on Saturday evenings and a chance for me to sit down with a bowl of popcorn and watch it with my girls. We started watching it together in 2015 when we cheered for Peter Andre and his connection with the medical profession. Now we are thrilled to see Dr Punam Krishan bringing Bollywood to Strictly for the first time and increasing its diversity. Go for it, Punam!

I attended a meeting of Southwest LMCs in Taunton last week. Apart from the fairly grim 3-hour journey back (due to closure of the M5), it was great to hear neighbouring LMCs discuss their approach to collective action and interface issues.

Naturally, we have received lots of queries about GP collective action, mainly enquiring when resources will be available. So, in today’s newsletter we are happy to share some template letters for workload transfer, as well as narrative for patient text templates. We have asked One Care to download these templates directly into EMIS via Resource Publisher, and we will notify you when this has happened.

“Coming together is a beginning; keeping together is progress; working together is success.”  – Edward Everett Hale

Dr Shaba Nabi
Chair Avon LMC

This question has been asked repeatedly on both a local and national level. GPs are asking about the timeframe for collective action and the next steps for the national GP contract. I will attempt to respond to some of these queries with a few soundbites:

• GP Collective Action is more of a lifestyle change than a crash diet
• GP Collective Action should be renamed GP “Corrective Action”
• This is a reset and not a shutdown

None of the actions we are taking are in breach of contract, but they serve to manage an unsustainable workload. As such, they are for an indefinite period of time.

Regarding the national steer and the next steps after phase 1 of collective action, the 2025/26 contract will be negotiated by the GPC England Executive Team over the next few months. Once they have had a chance to appraise this and discuss with the committee, the profession will be advised of any next steps for action.
 

In response to your request to develop resources to assist with the pushback of workload transfer to general practice, we have developed template letters and narrative for patient communication. We will notify you when these template letters have been downloaded to EMIS via Resource Publisher.

These resources can also be found on the open section of the LMC website on GP Collective Action found here: https://avonlmc.co.uk/collective-action-2/

Prescribing workload transfer
Here is a template letter to be used specifically for inappropriate prescribing requests to general practice:
Template letter to decline prescribing

Here is an example text message to explain that you are declining a prescribing request:
Text template for declining prescribing

We have also produced some LMC guidance on the principles for Shared Care Prescribing:
Principles for Shared Care Prescribing

All other Workload Transfer
Here is a template letter to decline other types of workload transfer, such as fit notes and chasing secondary care investigations:
Template letter to decline workload transfer

Here is an example text template to explain you are declining workload transfer:
Text template for workload transfer

Resources to be shared in the next few weeks are:

• Generic Referral Form information – including an LMC steer on which specific referral forms should be retained
• A short video explaining collective action to all your practice staff
• Posters for your waiting room and website to help with workload transfer
• A summary document to explain how to locate all resources
• Data Sharing Guidance

This is now live so if you have already registered for this, you will find yourself added and welcomed by Rebecca Kemp very shortly. For those of you who haven’t registered, this is an excellent way to keep up to date with all LMC and national GPC communications. We will keep this group as “broadcast only” for the majority of the time, but intermittently allow group chat when we wish to seek timely feedback for activities.

Please register your interest here.

Question: We recently had a significant event where a patient was referred for an urgent referral and didn’t attend, resulting in a delayed diagnosis of cancer. What is the practice responsibility here?

Answer: This is a common scenario in general practice and there is no simple answer here. 
Firstly, there needs to be an assessment of various patient factors which would influence their understanding and ability to attend an appointment. These would include, but not restricted to:

• Mental Capacity
• Safeguarding issues
• Mental Health issues
• Disability
• Social/Housing issues
• Language issues

Secondly, the patient needs to be fully informed (and understand) the importance of attending an appointment and this must be fully documented.

For further advice, the MDU has written some helpful guidance on missed appointments.

The committee were informed that in these discussions, the limitations and flaws of ARRS as a mechanism were made clear to NHS England. It was highlighted that the ongoing employment of GPs needed to be via alternative vehicles such as the retainer or fellowship schemes based within practices rooted within their communities, rather than spread thinly across multiple practices and population footprints at PCN level. Furthermore, there could be an opportunity to then focus recruitment into under-doctored areas of increased deprivation where the workforce was most needed as opposed to further entrenchment of the inverse care law within general practice.

In addition to above, the inadequacy of the scheme to address the substantive GP unemployment crisis was made clear. Questions were also raised as to the potential for discrimination, superannuation, and ongoing employment liabilities.

The solution to the unemployment crisis was reiterated to be via increased core funding of practices to enable practices to directly employ or recruit partner GPs directly to serve their local communities. Despite objections we will continue to constructively work to improve the mechanism given that the funding into 2025/26 has been confirmed. An example being that such roles should not have additional barriers to specific outputs and employment must be via the BMA model salaried GP contract.

Dear all,

Today sees the launch of Patients First: Why General Practice is broken and how we can fix it. Our vision details the essential changes that need to happen to save general practice across England.

Patients First focuses on safety, stability and hope, presenting solutions for the new Government to work with us in rebuilding a transformed general practice for the benefit of our patients and improved long-term public health. 

GPs need an extra 11p per day, that’s £40 per patient per year, in 2025/26 to offer fair pay and conditions for practice employees, to take on more GPs, to deliver more GP appointments and help provide safer, better continuity of care for our patients.

We’ve shared Patients First: Why General Practice is broken and how we can fix it with the Secretary of State Wes Streeting, as well as with the Department for Health and NHS England leaders. We look forward to working with them to bring about essential changes and shape policies that will fix the front door to the NHS and bring back the family doctor. Safeguard general practice, and you safeguard the NHS.

Please share our vision too, with patients, friends and colleagues, while continuing to take collective action that will protect our patients and our practices.

Yours,?
Dr Katie Bramall-Stainer? 
Chair, General Practitioners Committee England

Attachment
Patients First – Why General Practice is Broken (Summary)
Patients First – Why General Practice is broken & how we can fix it

Read the latest GPC England bulletin here.

Read the IGPM statement here.

We are delighted to announce the new website for Avon LMC Safehouse. This offers support to GPs, Practice Managers and Nurses within the BNSSG area.
 
The safehouse allows access to online resources and signposts you to additional support if needed, both confidentially and anonymously.
 
Please go to https://avonsafehouse.co.uk/ for more information.

Make savings on products and services by utilising the Buying Group approved suppliers
 
The LMC Buying Group has an impressive list of suppliers that cover a variety of products and services, from stationery and office equipment to medical consumables and confidential information shredding.
 
We regularly identify savings between 20% and 45% made on office items from our supplier, Whittaker Workplace Solutions. They can supply your practice with everything it needs to run smoothly, including stationery and office products, catering and cleaning supplies and printer cartridges. To order from them, you can phone, email, fax or order online at all times.
 
If you are looking for a company that can provide confidential information protection and secure document shredding, hard-drive destruction and associated recycling services, the Buying Group have the perfect supplier for you. Through Shred-it’s partnership with the Buying Group, all members can access 50% off standard rates. Shred-it supplies their services to organizations of all sizes in the private, public and third sectors.
 
To access the discounts, you would have to sign up with the Buying Group. Membership is completely free for practices. For those of you who are already members, accessing these discounts is incredibly simple, all you have to do is visit the Buying Group’s website and click onto the supplier page you are interested in.

• 12th November 2024: Virtual LMC drop in, 13.00 – 14.00
• 22nd November 2024: England LMC Conference – London, all day
• 14th January 2025: Virtual LMC drop in, 13.00 – 14.00
• 11th March 2025: Virtual LMC drop in, 13.00 – 14.00

• Tuesday 8 October General practice bulletin (mailchi.mp)
• Thursday 3 October General practice bulletin (mailchi.mp)

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– LATEST TRAINING AND EVENTS –

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• 15th October – BCYP EduForum – Rashes in Children
  Signup Form
• 17th October – Understanding the use of FIT – testing for blood in poo
  Signup Form
• 24th October – BNSSG Cancer Lead Education Day 2024
  Signup Form
• 24th October – Dermoscopy Training – Part 2
  Signup Form
• 24th October – Blood Interpretation in Primary Care (Day 1 of 4)
  Signup Form

Please see here for full event details.
For further information please contact Bnssg.training.hub@nhs.net

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